NPIMap

Organization Active NPI

Mikyung Yun OD PC

  • Optometrist
  • St Charles, IL
National Provider Identifier
1801119987
Registry record updated Mar 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-009764 Issued in IL
Legal business name
MIKYUNG YUN OD PC
Practice address
150 Smith Rd
St Charles, IL 60174-5203
Phone
(630) 513-9566
Fax
(630) 513-9786
NPI assigned
Mar 3, 2010
Last updated
Mar 11, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mikyung BakerNPI 1124133459
Title
President
Phone
(630) 606-1618

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 046-009764 IL Primary

Addresses

Primary practice location

150 Smith Rd
St Charles, IL 60174-5203

Mailing address

150 Smith Rd
St Charles, IL 60174-5203

National Provider Directory

National Provider Directory

Locations

150 Smith Rd
St Charles, IL 60174
Phone (630) 513-9560

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1267574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299801600000",
    "number": "1801119987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 SMITH RD",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601745203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SMITH RD",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601745203",
            "telephone_number": "630-513-9566",
            "fax_number": "630-513-9786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIKYUNG YUN OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-03",
        "last_updated": "2011-03-11",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "MIKYUNG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-606-1618"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.